Free Guide to Hemorrhoid Treatment Options

Understanding Hemorrhoids: What They Are and Why They Occur

Hemorrhoids are swollen blood vessels in the rectal area. They affect millions of people each year, making them one of the most common health conditions in the United States. According to the American Society of Colon and Rectal Surgeons, about half of people experience hemorrhoid symptoms by age 50. Despite their prevalence, many people feel embarrassed discussing them, which sometimes delays treatment.

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Hemorrhoids come in two types: internal and external. Internal hemorrhoids develop inside the rectum, where you cannot see or feel them directly. They typically cause painless bleeding during bowel movements, though in some cases they may protrude and cause discomfort. External hemorrhoids form under the skin around the anus and can be itchy, painful, or tender, especially when sitting or during bowel movements.

Several factors increase the likelihood of developing hemorrhoids. Straining during bowel movements is a primary cause—this often happens when someone has constipation or diarrhea. Pregnancy increases risk as well, since the growing uterus puts pressure on veins in the lower abdomen, and hormonal changes soften tissues that normally support veins. Sitting for long periods, especially on the toilet, can contribute to hemorrhoid development. A low-fiber diet, which makes stools harder and requires more straining, is another common culprit. Certain medical conditions, like liver disease or heart problems that affect blood flow, may also play a role.

Age is a natural risk factor since tissues weaken over time. However, hemorrhoids can develop at any age, including in young adults and teenagers. Understanding what causes hemorrhoids matters because many of these risk factors are things you can modify through lifestyle changes.

Practical takeaway: Hemorrhoids result from pressure and straining in the rectal area. Recognizing your personal risk factors—whether constipation, prolonged sitting, pregnancy, or diet—helps you understand which prevention strategies may matter most for your situation.

Over-the-Counter Treatment Options and How They Work

Most people with hemorrhoid symptoms start with over-the-counter (OTC) treatments available at pharmacies without a prescription. These products address common symptoms like itching, pain, and discomfort. Understanding how different types work helps you choose an option that fits your needs.

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Topical creams and ointments are among the most popular OTC choices. Products containing hydrocortisone reduce inflammation and itching by calming the swollen tissue. Witch hazel, a natural astringent found in many hemorrhoid products, has been used for centuries and works by tightening tissues and reducing irritation. Many OTC creams combine multiple active ingredients—for example, a product might include hydrocortisone for inflammation, phenylephrine to reduce swelling, and pramoxine for numbing sensation. These products typically come in small tubes or jars and are applied directly to the affected area, usually two to three times daily or after bowel movements.

Medicated pads and wipes offer another convenient option, especially for people who prefer not to use creams. These pads, often containing witch hazel or hydrocortisone, can be used after each bowel movement. They are gentle and help keep the area clean without harsh wiping, which can irritate hemorrhoids further. Some people find pads easier to use than creams, particularly when away from home.

Oral medications available over the counter include pain relievers like acetaminophen or ibuprofen, which reduce pain and inflammation. Stool softeners containing docusate sodium help prevent constipation by making stools softer and easier to pass, which reduces straining. Fiber supplements, discussed in more detail in the next section, also fall into the OTC category and address an underlying cause of many hemorrhoid problems.

Suppositories are another OTC option. These small, bullet-shaped products are inserted into the rectum and release medication as they melt. They often contain hydrocortisone, cocoa butter, or other soothing ingredients. Suppositories work well for internal hemorrhoids or when external products are uncomfortable to apply.

Most OTC treatments begin showing results within a few days. However, if symptoms persist beyond two weeks, or if bleeding is heavy or accompanied by other concerning symptoms, consulting a healthcare provider becomes important to rule out other conditions.

Practical takeaway: OTC products address hemorrhoid symptoms through different methods—topical creams reduce inflammation, wipes keep the area clean, oral medications manage pain, and suppositories deliver medicine internally. You can often find these products at any pharmacy, and trying one type helps you discover what works best for your body.

Dietary and Lifestyle Changes That Reduce Hemorrhoid Symptoms

Changing what you eat and how you live offers one of the most effective ways to manage hemorrhoids and prevent them from returning. These changes address the root causes—constipation and straining—that lead to most hemorrhoid problems in the first place.

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Fiber intake stands out as particularly important. Fiber adds bulk to stool and helps it retain water, making bowel movements softer and easier to pass without straining. The Academy of Nutrition and Dietetics recommends 25 grams of fiber daily for women and 38 grams for men, though many Americans consume far less. Increasing fiber gradually helps your digestive system adjust without causing gas or bloating. Good sources include whole grains (oatmeal, brown rice, whole wheat bread), legumes (beans, lentils, chickpeas), vegetables (broccoli, carrots, sweet potatoes), and fruits (berries, pears, apples with skin). A simple change like switching from white bread to whole wheat or adding a side salad to meals boosts fiber without major disruption to your routine.

Hydration directly affects stool consistency. Drinking enough water—typically 6 to 8 glasses daily, though individual needs vary—keeps stools soft and reduces the urge to strain. Many people with hemorrhoids unknowingly drink too little water, especially if they also consume caffeine or alcohol, which can have dehydrating effects. Replacing some sodas or coffee with water makes a practical difference.

Bathroom habits matter more than many people realize. Spending excessive time on the toilet increases pressure in the rectal area, even if you are not actively straining. Experts recommend limiting toilet time to 5-10 minutes and avoiding reading or using phones while on the toilet, as these activities encourage lingering. After bowel movements, gentle wiping with soft, moistened toilet paper or wet wipes is gentler than dry paper. Some people benefit from using a bidet or squirt bottle for cleaning without friction.

Physical activity improves digestion and reduces constipation. Regular movement—whether walking, swimming, cycling, or other moderate exercise—helps your digestive system work smoothly. Even 30 minutes of activity most days makes a difference. However, avoid activities that increase abdominal pressure, like heavy weightlifting or straining exercises, especially if you currently have hemorrhoid symptoms.

Certain foods and substances may worsen symptoms in some people. Spicy foods can irritate the rectal area. Alcohol and caffeine can dehydrate you, leading to constipation. Processed foods often contain little fiber and may contribute to digestive problems. While these triggers vary between individuals—some people tolerate spicy food fine—paying attention to what worsens your symptoms guides your personal choices.

Practical takeaway: Eating more fiber, drinking enough water, spending less time on the toilet, and moving your body regularly address the constipation and straining that cause most hemorrhoids. These changes also reduce your risk of hemorrhoids returning after treatment.

Medical Procedures Available When Conservative Treatment Is Insufficient

When over-the-counter products and lifestyle changes do not adequately control hemorrhoid symptoms after several weeks, healthcare providers offer several in-office procedures. These procedures are minimally invasive, meaning they involve smaller incisions or no incisions at all, and most are performed in an outpatient setting where you go home the same day.

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Rubber band ligation is among the most commonly performed procedures for internal hemorrhoids. During this procedure, a doctor places a special rubber band around the base of an internal hemorrhoid, cutting off its blood supply. The hemorrhoid shrinks and falls off within 7-10 days, typically during a bowel movement. The procedure takes just a few minutes and causes minimal discomfort during the procedure itself, though some